Individual
MADISON KATE BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 45TH ST S, FARGO, ND 58104-8970
(701) 356-4384
(000) 000-0000
Mailing address
3401 45TH ST S, FARGO, ND 58104-8970
(701) 356-4384
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2018
Last updated
08/27/2020
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